Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally-representative data

Abstract Background Complications of unsafe abortion are a leading cause of maternal mortality in sub-Saharan Africa. Adolescents and young women are disproportionately represented among those at risk of these complications. Currently, we know little about the factors associated with young women’s t...

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Main Authors: Boniface A. Ushie, Chimaraoke O. Izugbara, Michael M. Mutua, Caroline W. Kabiru
Format: Article
Language:English
Published: BMC 2018-02-01
Series:BMC Women's Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12905-018-0521-4
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author Boniface A. Ushie
Chimaraoke O. Izugbara
Michael M. Mutua
Caroline W. Kabiru
author_facet Boniface A. Ushie
Chimaraoke O. Izugbara
Michael M. Mutua
Caroline W. Kabiru
author_sort Boniface A. Ushie
collection DOAJ
description Abstract Background Complications of unsafe abortion are a leading cause of maternal mortality in sub-Saharan Africa. Adolescents and young women are disproportionately represented among those at risk of these complications. Currently, we know little about the factors associated with young women’s timing of abortion. This study examined the timing of abortion as well as factors influencing it among adolescents and young women aged 12–24 years who sought post-abortion care (PAC) in health facilities in Kenya. Methods We draw on data from a cross-sectional study on the magnitude and incidence of induced abortion in Kenya conducted in 2012. The study surveyed women presenting with a diagnosis of incomplete, inevitable, missed, complete, or septic abortion over a one-month data collection period in 328 health facilities (levels 2–6). Survey data, specifically, from adolescents and young women were analyzed to examine their characteristics, the timing of abortion, and the factors associated with the timing of abortion. Results One thousand one hundred forty-five adolescents and young women presented for PAC during the data collection period. Eight percent of the women reported a previous induced abortion and 78% were not using a modern method of contraception about the time of conception. Thirty-nine percent of the index abortions occurred after 12 weeks of gestation. A greater proportion of women presenting with late abortions (more than 12 weeks gestational age) (46%) than those presenting with early abortions (33%) presented with severe complications. Controlling for socio-demographic and reproductive history, timing of abortion was significantly associated with place of residence (marginal), education, parity, clinical stage of abortion and level of severity. Conclusions Late-term abortions were substantial, and may have contributed substantially to the high proportion of women with post-abortion complications. Efforts to reduce the severity of abortion-related morbidities and mortality must target young women, particularly those living in rural and other remote areas. Interventions to reduce unintended pregnancies in this population are also urgently needed to improve early pregnancy detection and timely care seeking.
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spelling doaj.art-ec55399b715b4955bc850aaa0db86dd92022-12-22T03:36:56ZengBMCBMC Women's Health1472-68742018-02-011811810.1186/s12905-018-0521-4Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally-representative dataBoniface A. Ushie0Chimaraoke O. Izugbara1Michael M. Mutua2Caroline W. Kabiru3African Population and Health Research CenterAfrican Population and Health Research CenterAfrican Population and Health Research CenterAfrican Population and Health Research CenterAbstract Background Complications of unsafe abortion are a leading cause of maternal mortality in sub-Saharan Africa. Adolescents and young women are disproportionately represented among those at risk of these complications. Currently, we know little about the factors associated with young women’s timing of abortion. This study examined the timing of abortion as well as factors influencing it among adolescents and young women aged 12–24 years who sought post-abortion care (PAC) in health facilities in Kenya. Methods We draw on data from a cross-sectional study on the magnitude and incidence of induced abortion in Kenya conducted in 2012. The study surveyed women presenting with a diagnosis of incomplete, inevitable, missed, complete, or septic abortion over a one-month data collection period in 328 health facilities (levels 2–6). Survey data, specifically, from adolescents and young women were analyzed to examine their characteristics, the timing of abortion, and the factors associated with the timing of abortion. Results One thousand one hundred forty-five adolescents and young women presented for PAC during the data collection period. Eight percent of the women reported a previous induced abortion and 78% were not using a modern method of contraception about the time of conception. Thirty-nine percent of the index abortions occurred after 12 weeks of gestation. A greater proportion of women presenting with late abortions (more than 12 weeks gestational age) (46%) than those presenting with early abortions (33%) presented with severe complications. Controlling for socio-demographic and reproductive history, timing of abortion was significantly associated with place of residence (marginal), education, parity, clinical stage of abortion and level of severity. Conclusions Late-term abortions were substantial, and may have contributed substantially to the high proportion of women with post-abortion complications. Efforts to reduce the severity of abortion-related morbidities and mortality must target young women, particularly those living in rural and other remote areas. Interventions to reduce unintended pregnancies in this population are also urgently needed to improve early pregnancy detection and timely care seeking.http://link.springer.com/article/10.1186/s12905-018-0521-4AbortionAbortion-related complicationsPost-abortion careAdolescentsYoung womenTiming of abortion
spellingShingle Boniface A. Ushie
Chimaraoke O. Izugbara
Michael M. Mutua
Caroline W. Kabiru
Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally-representative data
BMC Women's Health
Abortion
Abortion-related complications
Post-abortion care
Adolescents
Young women
Timing of abortion
title Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally-representative data
title_full Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally-representative data
title_fullStr Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally-representative data
title_full_unstemmed Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally-representative data
title_short Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally-representative data
title_sort timing of abortion among adolescent and young women presenting for post abortion care in kenya a cross sectional analysis of nationally representative data
topic Abortion
Abortion-related complications
Post-abortion care
Adolescents
Young women
Timing of abortion
url http://link.springer.com/article/10.1186/s12905-018-0521-4
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